Regressive changes of the teeth include a variety of alterations in the dental tissues, mechanical tear and wear of tooth is a consequence of both pathological and physiological means. Tooth surface loss can be classified primarily as attrition, abrasion, abfraction and erosion. To assess the prevalence of attrition, abrasion, erosion and abfraction among patients visiting private college hospital in Chennai. Data of the patients retrieved was from the dental records of the hospital. Patients with attrition, abrasion, erosion and abfraction were shortlisted. Total study sample, n=7300 patients. Data was tabulated in excel and statistically analysed. From the statistical analysis, it was significant that the most prevalent type of tooth wear was attrition(49.7%), followed by abrasion(48.3%), erosion(1%) and abfraction(0.97%) (chi square test-p-value= 0.000-significant). Within the limitations of this study, it showed that there was a significant prevalence of attrition followed by abrasion, erosion and abfraction with a male predilection, predominantly between the age group of 41-60 years, reported to private college hospital in Chennai.